Integrative Package
The Integrative Package
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Genetic Neuropsychiatric panel and Urine Neurotransmitters levels are the two tests made by the two different and unrelated laboratories tests.
Genetic laboratory analyzes a genetic test for you. Genetic test cost is 100% covered by Medicare, but the majority of the medical insurances require $399 copay. The test is not covered by Medi-Cal. Before submitting the specimens to the genetic lab, we’d recommend you to contact the laboratory directly (you can ask for their informational booklet at the front desk), and personally inquire about the amount of your copay, if any. If the genetic test is affordable to
you, our front desk staff can help you to correctly collect the genetic material (a swab from the oral cavity mucosa), open an account with the lab for you, and send the collected specimen to the laboratory. You can also do it yourself without our help as soon as all genetic panels are included in your request form. When the genetic test results arrive to us, they would require interpretation. Our office charges additional $350 for that.
Biochemical laboratory is another laboratory. It uses a special test to detect up to19
brain neurotransmitters and their derivatives excreted through the urine. The specimen you supposed to collect is urine. The laboratory doesn’t bill insurances and charges cash for its services. We have an account with the lab, and can provide you with the testing kit, which you take home. You’d have to collect the urine following the instruction the laboratory provides. The specimen you collect has to be mailed in the prepaid envelope on Monday, Tuesday or Wednesday to avoid weekends' arrivals.
When the results from the both laboratories arrive, we have to integrate the data into one system, and develop individualized treatment plan, which, besides medications, usually includes herbs and nutritional supplements. This work requires a significant amount of extra time not covered by any insurance. Instead of charging separately for Neurotransmitters laboratory fees, interpretation and integration of Neurotransmitter and Genetic data, we established a flat fee of $1500 for the both test (that is not included $399 copay, if any from Genetic Lab.) We'll take this amount as a deposit when giving you the Neurotransmitter test kit.* (Your deposit is fully refundable in case you change your mind and return the unused kit back to the office.)
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The Purpose of the Testing and the Information provided by the two tests
The genetic test provides information about the genes responsible for brain functioning and a patient’s anticipated reaction to each of the psychiatric medications. Because each gene consists of two alleles: one from mom and one from dad, in the situations when only one of the two is abnormal, it is not possible to predict which one of the alleles dominates, and in to what degree. There are some other factors, including environmental, influencing the genes’ expression, and the net-effect of their action, so called Gene Expression in Phenotype. If the genetic test is not completely able to predict the final results, what would? For that purpose, the urine Neurotransmitters test is used.
Knowing the amount of neurotransmitters helps us to understand the effects of the genotype on the brain chemistry, and which of the neurotransmitters are responsible for the experienced by the patient symptoms. At the same time genetic markers explain the roots of the neurotransmitters' abnormalities. Simply speaking, if each of the tests taken separately would provide us with 25% of the information needed, taken together would give us 90%. We have to also keep in mind, that outside of psychological, electroconvulsive and magnetic therapies, the only other currently used in medicine methods to influence brain activity are chemical. Psychotropic medications, food supplements, herbs and minerals are all chemical substances. Knowing neurotransmitters levels ("brain chemistry") is definitely helping us to use those chemicals more selectively, that way minimizing side effects, and the time spent on "trials and errors”.
The information from the tests is highly technical and specialized. It is advisable to familiarize yourself with basic Genetic and Nerves System terminology before our meeting, if you want the tests to be interpreted to you. You also have to know, that the information derived from the biological tests is not suitable for DSM-5 labeling your psychiatric diagnosis. The names Major Depressive Disorder, Bipolar Affective disorder, PTSD, Panic disorder, Generalized Anxiety disorder, ADHD, and so on are given to the mental conditions based on symptom-oriented descriptive model, adopted by American Psychiatric Association in Diagnostic Statistical Manual (DSM). This diagnostic model has nothing to do with the biological model we use, because it is not based on genetic, physiological, biochemical, or other objective findings related to our brain-body functioning.
The information we derive from the genetic and neurotransmitters tests is biological and objective. It is used to answer a question, what biochemical and genetic abnormalities could be responsible for your mental condition, and which tools, including medications and nutritional supplements, could be used to correct them.
The genetic and neurotransmitters laboratory usually accompany their results with their interpretational reports. Occasionally the patients get frustrated due to not understanding the meaning of what they read in those reports. Because the reports are computer-generated and not integrated with the rest of the information derived from the patient’s, including history, previous and current treatment, other tests results, the reports are not individualized and have very little relevance to the concrete individual. I’d advice to pay little attention to those reports, and leave them to me for analysis.
Hopefully, the above information is found to be helpful.
Vitaliy Shaulov, MD